Healthcare Provider Details

I. General information

NPI: 1114900396
Provider Name (Legal Business Name): BAY AREA CARDIOLOGY MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 E STANLEY BLVD SUITE 207
LIVERMORE CA
94550-4200
US

IV. Provider business mailing address

1133 E STANLEY BLVD SUITE 207
LIVERMORE CA
94550-4200
US

V. Phone/Fax

Practice location:
  • Phone: 925-294-9037
  • Fax: 925-294-9272
Mailing address:
  • Phone: 925-294-9037
  • Fax: 925-294-9272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: AYMAN A HOSNY
Title or Position: PARTNER
Credential: M.D.
Phone: 925-294-9037